Provider Demographics
NPI:1598367112
Name:DOLINAR, KAITLIN JOY (PHYSICIAN ASSISTANT)
Entity Type:Individual
Prefix:
First Name:KAITLIN
Middle Name:JOY
Last Name:DOLINAR
Suffix:
Gender:F
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 457
Mailing Address - Street 2:
Mailing Address - City:WRIGHTWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:92397-0457
Mailing Address - Country:US
Mailing Address - Phone:661-549-5435
Mailing Address - Fax:
Practice Address - Street 1:19333 BEAR VALLEY RD STE 105
Practice Address - Street 2:
Practice Address - City:APPLE VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92308-5149
Practice Address - Country:US
Practice Address - Phone:760-490-0592
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-09
Last Update Date:2022-01-10
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant